Note: For women going through IVF only
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1. How old are you?
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2. Are you married or in a serious relationship?
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3. Do you have children?
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4. Have you gone through infertility treatment with a previous pregnancy?
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5. Has anyone else in your family experienced infertility?
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6. How old were you when you started infertility treatment?
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7. If you waited until over 35 to try to get pregnant, why?
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8. What options have you already tried to combat infertility? Select all that apply.
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9. How much time a month are you spending on IVF (research, doctor's visits, travel to and from doctor, shots, etc.)?
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10. How much money would you be willing to spend on infertility treatments in order to get pregnant?
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11. Does your health insurance cover infertility treatments?
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12. How has IVF affected your sex life?
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13. How stressed do you feel about going through IVF?
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14. Which side effects have you experienced from the hormones you take for IVF? Choose all that apply.
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15. How many times a day do you typically think about getting pregnant?
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16. How has the IVF process affected your relationships with friends and family?
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17. Who do you turn to for help dealing with infertility? Choose all that apply.
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18. How has infertility affected your relationship with your partner?
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19. Would you be willing to risk your relationship with your partner to get pregnant?
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20. How do you feel around women who are pregnant?
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21. At what point did you decide to do IVF after trying to get pregnant on your own?
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22. How far do you travel for IVF treatment?
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23. Are you hoping for twins as a result of IVF treatment?
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24. Are you concerned about the possibility of high-order multiple pregnancy (triplets or more) as a result of IVF treatment?
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25. If you get pregnant with high-order multiples (triplets or more), would you consider selective reduction (terminating one or more fetuses)?
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26. How many times would you consider doing IVF to help you conceive?

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27. At what age you would no longer be willing to pursue IVF (whether with your own or donor eggs)?

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28. If IVF does not work for you, would you consider adoption?
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29. What alternative approaches, if any, have you tried to help you conceive? Choose all that apply.

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